Pain in the kneecap (patella) is very common in young athletes. It’s estimated that up to 15% of adolescents get some degree of patellofemoral pain. Most can be treated with rest, ice, non-steroidal anti-inflammatory drugs (NSAIDs) and sometimes rehab exercises. But instability of the patella — known as patellofemoral instability — is relatively less common, and more worrisome for children and adolescents.
The term “patellofemoral instability” can refer to either a traumatic injury in which a person dislocates their patella, or just general instability in the knee that a person may feel or a physician may observe upon examination. In both cases, it’s important the individual receives the proper treatment in order to avoid long-term damage.
Thriving talked to Dr. Matthew Milewski, a pediatric orthopedic sports medicine surgeon in Boston Children’s Orthopedics and Sports Medicine Center, about what kids and parents should be aware of if they experience this knee condition.
Many parents recognize there are tremendous benefits to youth sports participation, such as building relationships with peers and coaches and developing a healthy lifestyle. But for some kids, focusing on one sport at a young age can be too much of a good thing.
Sports specialization — intense training for a single sport with exclusion of other sports — has become increasingly popular at younger and younger ages.
Researchers suggest this specialization period occurs between the ages of 6 and 12. At these ages, some common overuse pediatric injuries, such as patellofemoral pain syndrome and Osgood-Schlatter disease, are four times greater in sport-specialized athletes. Diversified sport participation promotes the development of motor skills and limits repetitive stress on kids’ growing bones.
This is why pediatric sports medicine professionals recommend athletes delay specialization until late adolescence (16 to 18 years old) to minimize risk for injury and psychological stress.
Here are some pointers to keep young athletes healthy and in the game.
Take part in recreational play.
It is important for young athletes to enjoy neighborhood games such as tag, capture the flag, kick-the-can, wiffle ball and other games. These keep kids active and promote healthy living. Performing movements that differ from a specific sport are more likely to reduce the young athlete’s risk of injury.
Even switching from ice hockey, which can focus on repetitive drills, to street hockey, which is recreational play, may lessen injury risk.
Take advantage of the off-season.
Usually there are a few weeks between the conclusion of one season and the beginning of the next. This is a great time to hang up the equipment. The athlete can focus on recovering, taking a few days off to rest and then working on some easy strength, flexibility and other modes of cardiovascular activity, including recreational play.
Participate in one sport a season.
Often young athletes participate in more than one sport a season. Before the ages of 16-18, youth should participate in a variety of different sports throughout the year and limit organized participation to one sport a season. Kicking a soccer ball differs from shooting a basketball and offers the body a variation in movement. This benefits kids because not only does the risk of injury decrease, but it also gives the athlete the ability to develop different motor skills.
Begin strength training.
Parents and coaches believe young athletes are strong from the sports they play. Sports develop strength to a certain degree, but a well-rounded strength program corrects imbalances and promotes proper movement to reduce injuries in sport. Ultimately, the stronger the athlete, the more likely she is to reduce her risk for injury.
A common misconception is that strength training means lifting heavy weights, but strength training can be as simple as a plank or a bodyweight squat. Any uniform exercise performed correctly with repetition that allows children’s muscles to respond and produce a movement will create strength.
There is no minimum age requirement to beginning strength training, but athletes should be able to follow directions and demonstrate balance.
Talk to a sport psychologist if your child seems stressed about sports participation.
A sports psychologist can be a great resource for an athlete to voice concerns about the mental components of a sport, such as preparing for tryouts, overcoming a tough loss and setting personal goals. Psychological stress can lead to an injury or burn-out. It also may result in some athletes quitting their sport at a young age.